Published time: 27 January 2020
Keywords: SARS, travel, coronavirus, pneumonia, outbreak, zoonosis, Wuhan
A novel coronavirus emerging from Wuhan, China in late December 2019 is currently spreading to other provinces in mainland China and international destinations across East Asia. At the time of writing, cases have been confirmed in Beijing, Shanghai, Hong Kong, Macau and multiple cities in Guangdong province, with more than 500 cases confirmed across China.1 Furthermore, several cases have spread internationally via air travel2 to Japan, South Korea, Taiwan, Thailand, and the USA. A recent modeling study concluded that for these international exportations to be observed, the outbreak in China should be substantially larger than is reflected by confirmed case counts.3 Currently, many public health interventions are based on scenarios where Wuhan is the primary source of new cases.4 While there are currently no documented transmission chains outside of the Wuhan region, should a scenario arise where this novel coronavirus spreads more broadly to and within other Chinese cities, we evaluated how global patterns of disease dispersion might change. Using 2019 data from the International Air Transport Association (IATA), we identified all cities in China that received at least 100 000 airline passengers from Wuhan during February through April 2019. We analyzed international airline passenger trips from the following 10 cities: Wuhan, Beijing, Shanghai, Kunming, Chengdu, Xiamen, Haikou, Guangzhou, Shenzhen, and Hong Kong.
Potential for global spread of a novel coronavirus from China